Inferior Vena Cava Filter Placed in Neurologic Intensive Care Unit: Effectiveness, Retrieval Rate, and Mortality

Area of Science:

• Neurology
• Critical Care Medicine
• Vascular Surgery

Background:

• Patients in neurologic intensive care units (NICU) frequently require inferior vena cava filters (IVCF) to manage venous thrombotic events.
• Understanding IVCF effectiveness, retrieval rates, and associated mortality is crucial for optimizing care in this high-risk population.

Purpose of the Study:

• To evaluate the effectiveness of IVCF in preventing post-placement pulmonary embolism (PE).
• To determine the rate of IVCF retrieval in NICU patients.
• To identify factors associated with in-hospital mortality and filter retrieval.

Main Methods:

• A retrospective review of 175 NICU patients who underwent IVCF placement between April 2015 and December 2020.
• Analysis of primary outcomes including post-filter PE, filter retrieval, and in-hospital mortality.
• Logistic regression models were used to identify factors associated with primary outcomes.

Main Results:

• IVCF placement was successful in all patients, with a low rate of post-filter PE (1.7%).
• The overall filter retrieval rate was 20.8%, with a median dwelling time of 9 months.
• Higher Sequential Organ Failure Assessment (SOFA) and Simplified Acute Physiology Scores (SAPS) were associated with increased in-hospital mortality, while modified Rankin Score (mRS) at discharge predicted retrieval success.

Conclusions:

• IVCF is effective in preventing PE in NICU patients, but retrieval rates are low, particularly in those with worse functional outcomes.
• Higher SOFA and SAPS scores are linked to mortality, highlighting the need for careful patient selection and improved retrieval strategies.